Breathing Motion Pattern in Cyclists: Role of Inferior against Superior Thorax Compartment

The thoracoabdominal breathing motion pattern is being considered in sports training because of its contribution, along with other physiological adaptations, to overall performance. We examined whether and how experience with cycling training modifies the thoracoabdominal motion patterns. We utilized optoelectronic plethysmography to monitor ten trained male cyclists and compared them to ten physically active male participants performing breathing maneuvers. Cyclists then participated in a self-paced time trial to explore the similarity between that observed during resting breathing. From the 3D coordinates of 32 markers positioned on each participant's trunk, we calculated the percentage of contribution of the superior thorax, inferior thorax, and abdomen and the correlation coefficient among these compartments. During the rest maneuvers, the cyclists showed a thoracoabdominal motion pattern characterized by an increased role of the inferior thorax relative to the superior thorax (26.69±5.88%, 34.93±5.03%; p=0.002, respectively), in contrast to the control group (26.69±5.88%; 25.71±6.04%, p=0.4, respectively). In addition, the inferior thorax showed higher coordination in phase with the abdomen. Furthermore, the results of the time trial test underscored the same pattern found in cyclists breathing at rest, suggesting that the development of a permanent modification in respiratory mechanics may be associated with cycling practice.

Flexible Matrices for the Encapsulation of Plant Wearable Sensors: Influence of Geometric and Color Features on Photosynthesis and Transpiration

The safeguarding of plant health is vital for optimizing crop growth practices, especially in the face of the biggest challenges of our generation, namely the environmental crisis and the dramatic changes in the climate. Among the many innovative tools developed to address these issues, wearable sensors have recently been proposed for monitoring plant growth and microclimates in a sustainable manner. These systems are composed of flexible matrices with embedded sensing elements, showing promise in revolutionizing plant monitoring without being intrusive. Despite their potential benefits, concerns arise regarding the effects of the long-term coexistence of these devices with the plant surface. Surprisingly, a systematic analysis of their influence on plant physiology is lacking. This study aims to investigate the effect of the color and geometric features of flexible matrices on two key plant physiological functions: photosynthesis and transpiration. Our findings indicate that the negative effects associated with colored substrates, as identified in recent research, can be minimized by holing the matrix surface with a percentage of voids of 15.7%. This approach mitigates interference with light absorption and reduces water loss to a negligible extent, making our work one of the first pioneering efforts in understanding the intricate relationship between plant wearables' features and plant health.

Optimizing Sensor Placement for Temperature Mapping during Ablation Procedures

Accurately mapping the temperature during ablation is crucial for improving clinical outcomes. While various sensor configurations have been suggested in the literature, depending on the sensors' type, number, and size, a comprehensive understanding of optimizing these parameters for precise temperature reconstruction is still lacking. This study addresses this gap by introducing a tool based on a theoretical model to optimize the placement of fiber Bragg grating sensors (FBG) within the organ undergoing ablation. The theoretical model serves as a general framework, allowing for adaptation to various situations. In practical application, the model provides a foundational structure, with the flexibility to tailor specific optimal solutions by adjusting problem-specific data. We propose a nonlinear and nonconvex (and, thus, only solvable in an approximated manner) optimization formulation to determine the optimal distribution and three-dimensional placement of FBG arrays. The optimization aims to find a trade-off among two objectives: maximizing the variance of the expected temperatures measured by the sensors, which can be obtained from a predictive simulation that considers both the type of applicator used and the specific organ involved, and maximizing the squared sum of the distances between the sensor pairs. The proposed approach provides a trade-off between collecting diverse temperatures and not having all the sensors concentrated in a single area. We address the optimization problem through the utilization of approximation schemes in programming. We then substantiate the efficacy of this approach through simulations. This study tackles optimizing the FBGs' sensor placement for precise temperature monitoring during tumor ablation. Optimizing the FBG placement enhances temperature mapping, aiding in tumor cell eradication while minimizing damage to surrounding tissues.

Instrumented treadmill for run biomechanics analysis: a comparative study

This study aims compare the spatiotemporal and kinematic running parameters obtained by the WalkerView (Tecnobody, Bergamo, Italy) with those recorded by a optoelectronic 3D motion capture system. Seventeen participants were simultaneously recorded by the WalkerView and a motion capture system during running tests on the WalkerView at two different speeds (i.e., 8 km/h and 10 km/h). Per each parameter and speed the Root Mean Square Error (RMSE), the intraclass correlation coefficient (ICC), and the mean of the difference (MOD) and limits of agreement (LOAs) indexes obtained from Bland-Altman analysis were used to compare the two systems. ICCs show an excellent agreement for the mean step time and the cadence at both testing speeds (ICC=0.993 at 8 km/h; ICC=0.998 at 10 km/h); a lower agreement was found for all the kinematic variables. Small differences for some spatio-temporal parameters and greater differences for the kinematic variables were found. Therefore, WalkerView could represent a practical, accessible, and less expensive tool for clinicians, researchers, and sports trainers to assess the characteristics spatio-temporal parameters of running in non-laboratory settings.

Wearable Systems for Unveiling Collective Intelligence in Clinical Settings

Nowadays, there is an ever-growing interest in assessing the collective intelligence (CI) of a team in a wide range of scenarios, thanks to its potential in enhancing teamwork and group performance. Recently, special attention has been devoted on the clinical setting, where breakdowns in teamwork, leadership, and communication can lead to adverse events, compromising patient safety. So far, researchers have mostly relied on surveys to study human behavior and group dynamics; however, this method is ineffective. In contrast, a promising solution to monitor behavioral and individual features that are reflective of CI is represented by wearable technologies. To date, the field of CI assessment still appears unstructured; therefore, the aim of this narrative review is to provide a detailed overview of the main group and individual parameters that can be monitored to evaluate CI in clinical settings, together with the wearables either already used to assess them or that have the potential to be applied in this scenario. The working principles, advantages, and disadvantages of each device are introduced in order to try to bring order in this field and provide a guide for future CI investigations in medical contexts.

A review on radiofrequency, laser, and microwave ablations and their thermal monitoring through fiber Bragg gratings

Thermal ablation of tumors aims to apply extreme temperatures inside the target tissue to achieve substantial tumor destruction in a minimally invasive manner. Several techniques are comprised, classified according to the type of energy source. However, the lack of treatment selectivity still needs to be addressed, potentially causing two risks: i) incomplete tumor destruction and recurrence, or conversely, ii) damage of the surrounding healthy tissue. Therefore, the research herein reviewed seeks to develop sensing systems based on fiber Bragg gratings (FBGs) for thermal monitoring inside the lesion during radiofrequency, laser, and microwave ablation. This review shows that, mainly thanks to multiplexing and minimal invasiveness, FBGs provide an optimal sensing solution. Their temperature measurements are the feedback to control the ablation process and allow to investigate different treatments, compare their outcomes, and quantify the impact of factors such as proximity to thermal probe and blood vessels, perfusion, and tissue type.

Current and future technologies for monitoring cultured meat: A review

The high population growth rate, massive animal food consumption, fast economic progress, and limited food resources could lead to a food crisis in the future. There is a huge requirement for dietary proteins including cultured meat is being progressed to fulfill the need for meat-derived proteins in the diet. However, production of cultured meat requires monitoring numerous bioprocess parameters. This review presents a comprehensive overview of various widely adopted techniques (optical, spectroscopic, electrochemical, capacitive, FETs, resistive, microscopy, and ultrasound) for monitoring physical, chemical, and biological parameters that can improve the bioprocess control in cultured meat. The methods, operating principle, merits/demerits, and the main open challenges are reviewed with the aim to support the readers in advancing knowledge on novel sensing systems for cultured meat applications.

Waveform Similarity Analysis Using Graph Mining for the Optimization of Sensor Positioning in Wearable Seismocardiography

OBJECTIVE

A major concern with wearable devices aiming to measure the seismocardiogram (SCG) signal is the variability of SCG waveform with the sensor position and a lack of a standard measurement procedure. We propose a method to optimize sensor positioning based on the similarity among waveforms collected through repeated measurements.

METHOD

we design a graph-theoretical model to evaluate the similarity of SCG signals and apply the proposed methodology to signals collected by sensors placed in different positions on the chest. A similarity score returns the optimal measurement position based on the repeatability of SCG waveforms. We tested the methodology on signals collected by using two wearable patches based on optical technology placed in two positions: mitral and aortic valve auscultation site (inter-position analysis). 11 healthy subjects were enrolled in this study. Moreover, we evaluated the influence of the subject's posture on waveform similarity with a view on ambulatory use (inter-posture analysis).

RESULTS

the highest similarity among SCG waveforms is obtained with the sensor on the mitral valve and the subject lying down.

CONCLUSIONS

our approach aims to be a step forward in the optimization of sensor positioning in the field of wearable seismocardiography. We demonstrate that the proposed algorithm is an effective method to estimate similarity among waveforms and outperforms the state-of-the-art in comparing SCG measurement sites.

SIGNIFICANCE

results obtained from this study can be exploited to design more efficient protocols for SCG recording in both research studies and future clinical examinations.

Intra-articular temperature monitoring during radiofrequency ablation in ex-vivo bovine hip joints via Fiber Bragg grating sensors

PURPOSE

Radiofrequency ablation is an increasingly used surgical option for ablation, resection and coagulation of soft tissues in joint arthroscopy. One of the major issues of thermal ablation is the temperature monitoring across the target areas, as cellular mortality is a direct consequence of thermal dosimetry. Temperatures from 45 °C to 50 °C are at risk of damage to chondrocytes. One of the most reliable tools for temperature monitoring is represented by fiber optic sensors, as they allow accurate and real-time temperature measurement via a minimally invasive approach. The aim of this study was to determine, by fiber Bragg grating sensors (FBGs), the safety of radiofrequency ablation in tissue heating applied to ex-vivo bovine hip joints.

METHODS

Ex vivo bovine hips were subjected to radiofrequency ablation, specifically in the acetabular labrum, for a total of two experiments. The WEREWOLF System (Smith + Nephew, Watford, UK) was employed in high operating mode and in a controlled ablation way. One optical fiber embedding seven FBGs was used to record multipoint temperature variations. Each sensor was 1 mm in length with a distance from edge to edge with each other of 2 mm.

RESULTS

The maximum variation was recorded in both the tests by the FBG1 (i.e., the closest one to the electrode tip) and was lower than to 2.8 °C. The other sensors (from FBG2 to FBG7) did not record a significant temperature change throughout the duration of the experiment (maximum up to 0.7 °C for FBG7).

CONCLUSIONS

No significant increase in temperature was observed at any of the seven sites. The sensor nearest to the radiofrequency source exhibited the highest temperature rise, but the variation was only 3 °C. The minimal temperature increase registered at the measurement sites, according to existing literature, is not expected to be cytotoxic. FBGs demonstrate the potential to fulfil the strict requirements for temperature measurements during arthroscopic surgery.

Breathing Chest Wall Kinematics Assessment through a Single Digital Camera: A Feasibility Study

The identification of respiratory patterns based on the movement of the chest wall can assist in monitoring an individual's health status, particularly those with neuromuscular disorders, such as hemiplegia and Duchenne muscular dystrophy. Thoraco-abdominal asynchrony (TAA) refers to the lack of coordination between the rib cage and abdominal movements, characterized by a time delay in their expansion. Motion capture systems, like optoelectronic plethysmography (OEP), are commonly employed to assess these asynchronous movements. However, alternative technologies able to capture chest wall movements without physical contact, such as RGB digital cameras and time-of-flight digital cameras, can also be utilized due to their accessibility, affordability, and non-invasive nature. This study explores the possibility of using a single RGB digital camera to record the kinematics of the thoracic and abdominal regions by placing four non-reflective markers on the torso. In order to choose the positions of these markers, we previously investigated the movements of 89 chest wall landmarks using OEP. Laboratory tests and volunteer experiments were conducted to assess the viability of the proposed system in capturing the kinematics of the chest wall and estimating various time-related respiratory parameters (i.e., fR, Ti, Te, and Ttot) as well as TAA indexes. The results demonstrate a high level of agreement between the detected chest wall kinematics and the reference data. Furthermore, the system shows promising potential in estimating time-related respiratory parameters and identifying phase shifts indicative of TAA, thus suggesting its feasibility in detecting abnormal chest wall movements without physical contact with a single RGB camera.

Respiratory Rate Estimation during Walking and Running Using Breathing Sounds Recorded with a Microphone

Emerging evidence suggests that respiratory frequency (f_R) is a valid marker of physical effort. This has stimulated interest in developing devices that allow athletes and exercise practitioners to monitor this vital sign. The numerous technical challenges posed by breathing monitoring in sporting scenarios (e.g., motion artifacts) require careful consideration of the variety of sensors potentially suitable for this purpose. Despite being less prone to motion artifacts than other sensors (e.g., strain sensors), microphone sensors have received limited attention so far. This paper proposes the use of a microphone embedded in a facemask for estimating f_R from breath sounds during walking and running. f_R was estimated in the time domain as the time elapsed between consecutive exhalation events retrieved from breathing sounds every 30 s. Data were collected from ten healthy subjects (both males and females) at rest and during walking (at 3 km/h and 6 km/h) and running (at 9 km/h and 12 km/h) activities. The reference respiratory signal was recorded with an orifice flowmeter. The mean absolute error (MAE), the mean of differences (MOD), and the limits of agreements (LOAs) were computed separately for each condition. Relatively good agreement was found between the proposed system and the reference system, with MAE and MOD values increasing with the increase in exercise intensity and ambient noise up to a maximum of 3.8 bpm (breaths per minute) and -2.0 bpm, respectively, during running at 12 km/h. When considering all the conditions together, we found an MAE of 1.7 bpm and an MOD ± LOAs of -0.24 ± 5.07 bpm. These findings suggest that microphone sensors can be considered among the suitable options for estimating f_R during exercise.

Design and Testing of a Smart Facemask for Respiratory Monitoring during Cycling Exercise

Given the importance of respiratory frequency (f_R) as a valid marker of physical effort, there is a growing interest in developing wearable devices measuring f_R in applied exercise settings. Biosensors measuring chest wall movements are attracting attention as they can be integrated into textiles, but their susceptibility to motion artefacts may limit their use in some sporting activities. Hence, there is a need to exploit sensors with signals minimally affected by motion artefacts. We present the design and testing of a smart facemask embedding a temperature biosensor for f_R monitoring during cycling exercise. After laboratory bench tests, the proposed solution was tested on cyclists during a ramp incremental frequency test (RIFT) and high-intensity interval training (HIIT), both indoors and outdoors. A reference flowmeter was used to validate the f_R extracted from the temperature respiratory signal. The smart facemask showed good performance, both at a breath-by-breath level (MAPE = 2.56% and 1.64% during RIFT and HIIT, respectively) and on 30 s average f_R values (MAPE = 0.37% and 0.23% during RIFT and HIIT, respectively). Both accuracy and precision (MOD ± LOAs) were generally superior to those of other devices validated during exercise. These findings have important implications for exercise testing and management in different populations.

Current understanding, challenges and perspective on portable systems applied to plant monitoring and precision agriculture

The devastating effects of global climate change on crop production and exponential population growth pose a major challenge to agricultural yields. To cope with this problem, crop performance monitoring is becoming increasingly necessary. In this scenario, the use of sensors and biosensors capable of detecting changes in plant fitness and predicting the evolution of their morphology and physiology has proven to be a useful strategy to increase crop yields. Flexible sensors and nanomaterials have inspired the emerging fields of wearable and on-plant portable devices that provide continuous and accurate long-term sensing of morphological, physiological, biochemical, and environmental parameters. This review provides an overview of novel plant sensing technologies by discussing wearable and integrated devices proposed for engineering plant and monitoring its morphological traits and physiological processes, as well as plant-environment interactions. For each application scenario, the state-of-the-art sensing solutions are grouped according to the plant organ on which they have been installed highlighting their main technological advantages and features. Finally, future opportunities, challenges and perspectives are discussed. We anticipate that the application of this technology in agriculture will provide more accurate measurements for farmers and plant scientists with the ability to track crop performance in real time. All of this information will be essential to enable rapid optimization of plants development through tailored treatments that improve overall plant health even under stressful conditions, with the ultimate goal of increasing crop productivity in a more sustainable manner.

Linear and Non-Linear Heart Rate Variability Indexes from Heart-Induced Mechanical Signals Recorded with a Skin-Interfaced IMU

Heart rate variability (HRV) indexes are becoming useful in various applications, from better diagnosis and prevention of diseases to predicting stress levels. Typically, HRV indexes are retrieved from the heart's electrical activity collected with an electrocardiographic signal (ECG). Heart-induced mechanical signals recorded from the body's surface can be utilized to record the mechanical activity of the heart and, in turn, extract HRV indexes from interbeat intervals (IBIs). Among others, accelerometers and gyroscopes can be used to register IBIs from precordial accelerations and chest wall angular velocities. However, unlike electrical signals, the morphology of mechanical ones is strongly affected by body posture. In this paper, we investigated the feasibility of estimating the most common linear and non-linear HRV indexes from accelerometer and gyroscope data collected with a wearable skin-interfaced Inertial Measurement Unit (IMU) positioned at the xiphoid level. Data were collected from 21 healthy volunteers assuming two common postures (i.e., seated and lying). Results show that using the gyroscope signal in the lying posture allows accurate results in estimating IBIs, thus allowing extracting of linear and non-linear HRV parameters that are not statistically significantly different from those extracted from reference ECG.

Plant-Wear: A Multi-Sensor Plant Wearable Platform for Growth and Microclimate Monitoring

Wearable devices are widely spreading in various scenarios for monitoring different parameters related to human and recently plant health. In the context of precision agriculture, wearables have proven to be a valuable alternative to traditional measurement methods for quantitatively monitoring plant development. This study proposed a multi-sensor wearable platform for monitoring the growth of plant organs (i.e., stem and fruit) and microclimate (i.e., environmental temperature-T and relative humidity-RH). The platform consists of a custom flexible strain sensor for monitoring growth when mounted on a plant and a commercial sensing unit for monitoring T and RH values of the plant surrounding. A different shape was conferred to the strain sensor according to the plant organs to be engineered. A dumbbell shape was chosen for the stem while a ring shape for the fruit. A metrological characterization was carried out to investigate the strain sensitivity of the proposed flexible sensors and then preliminary tests were performed in both indoor and outdoor scenarios to assess the platform performance. The promising results suggest that the proposed system can be considered one of the first attempts to design wearable and portable systems tailored to the specific plant organ with the potential to be used for future applications in the coming era of digital farms and precision agriculture.

Plant Growth Monitoring: Design, Fabrication, and Feasibility Assessment of Wearable Sensors Based on Fiber Bragg Gratings

Global climate change and exponential population growth pose a challenge to agricultural outputs. In this scenario, novel techniques have been proposed to improve plant growth and increase crop yields. Wearable sensors are emerging as promising tools for the non-invasive monitoring of plant physiological and microclimate parameters. Features of plant wearables, such as easy anchorage to different organs, compliance with natural surfaces, high flexibility, and biocompatibility, allow for the detection of growth without impacting the plant functions. This work proposed two wearable sensors based on fiber Bragg gratings (FBGs) within silicone matrices. The use of FBGs is motivated by their high sensitivity, multiplexing capacities, and chemical inertia. Firstly, we focused on the design and the fabrication of two plant wearables with different matrix shapes tailored to specific plant organs (i.e., tobacco stem and melon fruit). Then, we described the sensors' metrological properties to investigate the sensitivity to strain and the influence of environmental factors, such as temperature and humidity, on the sensors' performance. Finally, we performed experimental tests to preliminary assess the capability of the proposed sensors to monitor dimensional changes of plants in both laboratory and open field settings. The promising results will foster key actions to improve the use of this innovative technology in smart agriculture applications for increasing crop products quality, agricultural efficiency, and profits.

Preliminary Assessment of a Flexible Multi-Sensor Wearable System Based on Fiber Bragg Gratings for Respiratory Monitoring of Hemiplegic Patients

Respiratory diseases are common in post-stroke hemiplegic patients and represent a major social problem as they worsen the quality of life and reduce the life span. As a consequence, being able to monitor respiratory parameters such as the respiratory rate (RR) and assess the presence of respiratory asynchronies could be of paramount importance to define hemiplegics' health status. Moreover, RR is a useful parameter to investigate the level of fatigue and distress that these patients undergo during rehabilitation processes. Although motion capture systems and flowmeters are the leading instruments for respiratory pattern evaluation, smart wearable systems are gaining ever more acceptance since they allow continuous monitoring by detecting chest wall breathing displacements, ensuring reduced costs and no need for dedicated spaces. Among other sensing technologies, fiber Bragg grating (FBG) sensors have emerged thanks to their high sensitivity to strain, lightness, and multiplexing capability. In this work, a wearable system composed of four flexible dumbbell-shaped sensing modules is proposed for respiratory monitoring in hemiplegic patients. The system is light and easy to wear and can be adapted to any anthropometry thanks to the modular anchoring system. Its feasibility assessment in RR evaluation was performed on seven hemiplegic volunteers in eupnea and tachypnea breathing conditions. In addition, an explorative investigation was conducted to assess the system's ability to detect asynchronies between torso compartments. The good results suggest that this device could be a useful instrument to support clinicians and operators in hemiplegic patients' management.

Comparison between Chest-Worn Accelerometer and Gyroscope Performance for Heart Rate and Respiratory Rate Monitoring

The demand for wearable devices to simultaneously monitor heart rate (HR) and respiratory rate (RR) values has grown due to the incidence increase in cardiovascular and respiratory diseases. The use of inertial measurement unit (IMU) sensors, embedding both accelerometers and gyroscopes, may ensure a non-intrusive and low-cost monitoring. While both accelerometers and gyroscopes have been assessed independently for both HR and RR monitoring, there lacks a comprehensive comparison between them when used simultaneously. In this study, we used both accelerometers and gyroscopes embedded in a single IMU sensor for the simultaneous monitoring of HR and RR. The following main findings emerged: (i) the accelerometer outperformed the gyroscope in terms of accuracy in both HR and RR estimation; (ii) the window length used to estimate HR and RR values influences the accuracy; and (iii) increasing the length over 25 s does not provide a relevant improvement, but accuracy improves when the subject is seated or lying down, and deteriorates in the standing posture. Our study provides a comprehensive comparison between two promising systems, highlighting their potentiality for real-time cardiorespiratory monitoring. Furthermore, we give new insights into the influence of window length and posture on the systems' performance, which can be useful to spread this approach in clinical settings.

Investigating Stroke Effects on Respiratory Parameters Using a Wearable Device: A Pilot Study on Hemiplegic Patients

Quantitatively assessing personal health status is gaining increasing attention due to the improvement of diagnostic technology and the increasing occurrence of chronic pathologies. Monitoring physiological parameters allows for retrieving a general overview of the personal health status. Respiratory activity can provide relevant information, especially when pathologies affect the muscles and organs involved in breathing. Among many technologies, wearables may represent a valid solution for continuous and remote monitoring of respiratory activity, thus reducing healthcare costs. The most popular wearables used in this arena are based on detecting the breathing-induced movement of the chest wall. Therefore, their use in patients with impaired chest wall motion and abnormal respiratory kinematics can be challenging, but literature is still in its infancy. This study investigates the performance of a custom wearable device for respiratory monitoring in post-stroke patients. We tested the device on six hemiplegic patients under different respiratory regimes. The estimated respiratory parameters (i.e., respiratory frequency and the timing of the respiratory phase) demonstrated good agreement with the ones provided by a gold standard device. The promising results of this pilot study encourage the exploitation of wearables on these patients that may strongly impact the treatment of chronic diseases, such as hemiplegia.

FBG-Based Soft System for Assisted Epidural Anesthesia: Design Optimization and Clinical Assessment

Fiber Bragg grating sensors (FBGs) are considered a valid sensing solution for a variety of medical applications. The last decade witnessed the exploitation of these sensors in applications ranging from minimally invasive surgery to biomechanics and monitoring physiological parameters. Recently, preliminary studies investigated the potential impact of FBGs in the management of epidural procedures by detecting when the needle reaches the epidural space with the loss of resistance (LOR) technique. In this article, we propose a soft and flexible FBG-based system capable of detecting the LOR, we optimized the solution by considering different designs and materials, and we assessed the feasibility of the optimized soft sensor (SS) in clinical settings. The proposed SS addresses some of the open challenges in the use of a sensing solution during epidural punctures: it has high sensitivity, it is non-invasive, the sensing element does not need to be inserted within the needle, and the clinician can follow the standard clinical practice. Our analysis highlights how the material and the design impact the system response, and thus its performance in this scenario. We also demonstrated the system’s feasibility of detecting the LOR during epidural procedures.

Precordial Vibrations: A Review of Wearable Systems, Signal Processing Techniques, and Main Applications

Recently, the ever-growing interest in the continuous monitoring of heart function in out-of-laboratory settings for an early diagnosis of cardiovascular diseases has led to the investigation of innovative methods for cardiac monitoring. Among others, wearables recording seismic waves induced on the chest surface by the mechanical activity of the heart are becoming popular. For what concerns wearable-based methods, cardiac vibrations can be recorded from the thorax in the form of acceleration, angular velocity, and/or displacement by means of accelerometers, gyroscopes, and fiber optic sensors, respectively. The present paper reviews the currently available wearables for measuring precordial vibrations. The focus is on sensor technology and signal processing techniques for the extraction of the parameters of interest. Lastly, the explored application scenarios and experimental protocols with the relative influencing factors are discussed for each technique. The goal is to delve into these three fundamental aspects (i.e., wearable system, signal processing, and application scenario), which are mutually interrelated, to give a holistic view of the whole process, beyond the sensor aspect alone. The reader can gain a more complete picture of this context without disregarding any of these 3 aspects.

A Soft and Skin-Interfaced Smart Patch Based on Fiber Optics for Cardiorespiratory Monitoring

Wearables are valuable solutions for monitoring a variety of physiological parameters. Their application in cardiorespiratory monitoring may significantly impact global health problems and the economic burden related to cardiovascular and respiratory diseases. Here, we describe a soft biosensor capable of monitoring heart (HR) and respiratory (RR) rates simultaneously. We show that a skin-interfaced biosensor based on fiber optics (i.e., the smart patch) is capable of estimating HR and RR by detecting local ribcage strain caused by breathing and heart beating. The system addresses some of the main technical challenges that limit the wide-scale use of wearables, such as the simultaneous monitoring of HR and RR via single sensing modalities, their limited skin compliance, and low sensitivity. We demonstrate that the smart patch estimates HR and RR with high fidelity under different respiratory conditions and common daily body positions. We highlight the system potentiality of real-time cardiorespiratory monitoring in a broad range of home settings.

Silicone-Textile Composite Resistive Strain Sensors for Human Motion-Related Parameters

In recent years, soft and flexible strain sensors have found application in wearable devices for monitoring human motion and physiological parameters. Conductive textile-based sensors are good candidates for developing these sensors. However, their robust electro-mechanical connection and susceptibility to environmental factors are still an open challenge to date. In this work, the manufacturing process of a silicone-textile composite resistive strain sensor based on a conductive resistive textile encapsulated into a dual-layer of silicone rubber is reported. In the working range typical of biomedical applications (up to 50%), the proposed flexible, skin-safe and moisture resistant strain sensor exhibited high sensitivity (gauge factor of −1.1), low hysteresis (maximum hysteresis error 3.2%) and ease of shaping in custom designs through a facile manufacturing process. To test the developed flexible sensor, two applicative scenarios covering the whole working range have been considered: the recording of the chest wall expansion during respiratory activity and the capture of the elbow flexion/extension movements.

Multiscale and Multiphysics Modeling of Anisotropic Cardiac RFCA: Experimental-Based Model Calibration via Multi-Point Temperature Measurements

Radiofrequency catheter ablation (RFCA) is the mainstream treatment for drug-refractory cardiac fibrillation. Multiple studies demonstrated that incorrect dosage of radiofrequency energy to the myocardium could lead to uncontrolled tissue damage or treatment failure, with the consequent need for unplanned reoperations. Monitoring tissue temperature during thermal therapy and predicting the extent of lesions may improve treatment efficacy. Cardiac computational modeling represents a viable tool for identifying optimal RFCA settings, though predictability issues still limit a widespread usage of such a technology in clinical scenarios. We aim to fill this gap by assessing the influence of the intrinsic myocardial microstructure on the thermo-electric behavior at the tissue level. By performing multi-point temperature measurements on ex-vivo swine cardiac tissue samples, the experimental characterization of myocardial thermal anisotropy allowed us to assemble a fine-tuned thermo-electric material model of the cardiac tissue. We implemented a multiphysics and multiscale computational framework, encompassing thermo-electric anisotropic conduction, phase-lagging for heat transfer, and a three-state dynamical system for cellular death and lesion estimation. Our analysis resulted in a remarkable agreement between ex-vivo measurements and numerical results. Accordingly, we identified myocardium anisotropy as the driving effect on the outcomes of hyperthermic treatments. Furthermore, we characterized the complex nonlinear couplings regulating tissue behavior during RFCA, discussing model calibration, limitations, and perspectives.

Multi-ROI Spectral Approach for the Continuous Remote Cardio-Respiratory Monitoring from Mobile Device Built-In Cameras

Heart rate (HR) and respiratory rate (f_R) can be estimated by processing videos framing the upper body and face regions without any physical contact with the subject. This paper proposed a technique for continuously monitoring HR and f_R via a multi-ROI approach based on the spectral analysis of RGB video frames recorded with a mobile device (i.e., a smartphone's camera). The respiratory signal was estimated by the motion of the chest, whereas the cardiac signal was retrieved from the pulsatile activity at the level of right and left cheeks and forehead. Videos were recorded from 18 healthy volunteers in four sessions with different user-camera distances (i.e., 0.5 m and 1.0 m) and illumination conditions (i.e., natural and artificial light). For HR estimation, three approaches were investigated based on single or multi-ROI approaches. A commercially available multiparametric device was used to record reference respiratory signals and electrocardiogram (ECG). The results demonstrated that the multi-ROI approach outperforms the single-ROI approach providing temporal trends of both the vital parameters comparable to those provided by the reference, with a mean absolute error (MAE) consistently below 1 breaths·min^-1 for f_R in all the scenarios, and a MAE between 0.7 bpm and 6 bpm for HR estimation, whose values increase at higher distances.

Contactless Vital Signs Monitoring From Videos Recorded With Digital Cameras: An Overview

The measurement of physiological parameters is fundamental to assess the health status of an individual. The contactless monitoring of vital signs may provide benefits in various fields of application, from healthcare and clinical setting to occupational and sports scenarios. Recent research has been focused on the potentiality of camera-based systems working in the visible range (380-750 nm) for estimating vital signs by capturing subtle color changes or motions caused by physiological activities but invisible to human eyes. These quantities are typically extracted from videos framing some exposed body areas (e.g., face, torso, and hands) with adequate post-processing algorithms. In this review, we provided an overview of the physiological and technical aspects behind the estimation of vital signs like respiratory rate, heart rate, blood oxygen saturation, and blood pressure from digital images as well as the potential fields of application of these technologies. Per each vital sign, we provided the rationale for the measurement, a classification of the different techniques implemented for post-processing the original videos, and the main results obtained during various applications or in validation studies. The available evidence supports the premise of digital cameras as an unobtrusive and easy-to-use technology for physiological signs monitoring. Further research is needed to promote the advancements of the technology, allowing its application in a wide range of population and everyday life, fostering a biometrical holistic of the human body (BHOHB) approach.

Spatial temperature reconstructions in myocardial tissues undergoing radiofrequency ablations by performing high-resolved temperature measurements

BACKGROUND

Radiofrequency (RF) lesion creation is related to the heat propagation induced by RF application on tissues. Thermocouple embedded in the RF antenna are not able to predict deep tissue temperature at various level.

OBJECTIVES

This study aims to investigate the influence of power delivered on radiofrequency catheter ablation (RFCA) effects by means of high resolved 2D temperature maps.

METHODS

Three trials of four ablations (12 applications) were executed on each specimen of healthy excised swine myocardium in different application points at four RF power values (30 W, 40 W, 50 W, and 60 W) for a fixed treatment time. All the data provided by the fiber Bragg gratings (FBGs) were analyzed. Temperature variations (ΔT) in time recorded in the 28 sites of measurements were reported. Also, temperature maps showing the ΔT spatial distribution reached within the tissue at the end of the RFCA were produced and displayed, together with the representation of the lethal isotherm. Moreover, the time of achievement of the lethal isotherm at different tissue depths (from 1 to 8 mm) was evaluated for the four power settings.

RESULTS

Temperature trends reported comparable profiles across the different power settings. ΔT values and ΔT rising times showed dependence on the sensors' proximity to the RF energy source and on the set RF power. Temperature maps confirmed that heat propagation occurs preferentially along the width of the tissue than in the depth. Also, for the adjusted treatment time, no power setting guarantees lesions thicker than 6 mm.

CONCLUSIONS

ΔT maximal values and ΔT rising time strongly depends on the proximity of the tissues to RF energy source, as well as on the RF power setting. A plateau is reached in lesion size, regardless of the power setting. A first correlation between lesion size, power setting, and time to achieve lethal isotherms has been established.

A Wearable System Composed of FBG-Based Soft Sensors for Trunk Compensatory Movements Detection in Post-Stroke Hemiplegic Patients

In this study, a novel wearable system for the identification of compensatory trunk movements (CTMs) in post-stroke hemiplegic patients is presented. The device is composed of seven soft sensing elements (SSEs) based on fiber Bragg grating (FBG) technology. Each SSE consists of a single FBG encapsulated into a flexible matrix to enhance the sensor’s robustness and improve its compliance with the human body. The FBG’s small size, light weight, multiplexing capability, and biocompatibility make the proposed wearable system suitable for multi-point measurements without any movement restriction. Firstly, its manufacturing process is presented, together with the SSEs’ mechanical characterization to strain. Results of the metrological characterization showed a linear response of each SSE in the operating range. Then, the feasibility assessment of the proposed system is described. In particular, the device’s capability of detecting CTMs was assessed on 10 healthy volunteers and eight hemiplegic patients while performing three tasks which are representative of typical everyday life actions. The wearable system showed good potential in detecting CTMs. This promising result may foster the use of the proposed device on post-stroke patients, aiming at assessing the proper course of the rehabilitation process both in clinical and domestic settings. Moreover, its use may aid in defining tailored strategies to improve post-stoke patients’ motor recovery and quality of life.

Assessment of a Multi-Sensor FBG-based Wearable System in Sitting Postures Recognition and Respiratory Rate Evaluation of Office Workers

Due to prolonged incorrect sitting posture, upper body musculoskeletal disorders (UBMDs) are largely widespread among sedentary workers. Monitoring employees' sitting behaviors could be of great help in minimizing UBMDs' occurrence. In addition, being primarily influenced by psycho-physical stress conditions, respiratory rate (RR) would be a further useful parameter to delineate the workers' state of health. Wearable systems have emerged as a viable option for sitting posture and RR monitoring since enable continuous data collecting with no posture disturbances. Nevertheless, the main limits are poor fit, cumbersomeness, and movement restriction resulting in discomfort for the user. In addition, only few wearable solutions can track both these parameters contextually. To address these problems, in this study a flexible wearable system composed of seven modular sensing elements based on fiber Bragg grating (FBG) technology and designed to be worn on the back has been proposed to recognize the most common sitting postures (i.e., kyphotic, upright and lordotic) and estimate RR. The assessment was performed on ten volunteers showing good performances in postures recognition via Naïve Bayes classificator (accuracy >96.9%) and agreement with the benchmark in RR estimation (MAPE ranging between 0.74% and 3.83%, MODs close to zero, and LOAs between 0.76 bpm and 3.63 bpm). The method was then successfully tested on three additional subjects under different breathing conditions. The wearable system could offer great support for a better understanding of the workers' posture attitudes and contribute to gathering RR information to depict an overall picture of the users' state of health.

Epidural Steroid Injections for Low Back Pain: A Narrative Review

Low back pain represents a significant socioeconomic burden. Several nonsurgical medical treatments have been proposed for the treatment of this disabling condition. Epidural steroid injections (ESIs) are commonly used to treat lumbosacral radicular pain and to avoid surgery. Even though it is still not clear which type of conservative intervention is superior, several studies have proved that ESIs are able to increase patients' quality of life, relieve lumbosacral radicular pain and finally, reduce or delay more invasive interventions, such as spinal surgery. The aim of this narrative review is to analyze the mechanism of action of ESIs in patients affected by low back pain and investigate their current application in treating this widespread pathology.

A multi-point heart rate monitoring using a soft wearable system based on fiber optic technology

Early diagnosis can be crucial to limit both the mortality and economic burden of cardiovascular diseases. Recent developments have focused on the continuous monitoring of cardiac activity for a prompt diagnosis. Nowadays, wearable devices are gaining broad interest for a continuous monitoring of the heart rate (HR). One of the most promising methods to estimate HR is the seismocardiography (SCG) which allows to record the thoracic vibrations with high non-invasiveness in out-of-laboratory settings. Despite significant progress on SCG, the current state-of-the-art lacks both information on standardized sensor positioning and optimization of wearables design. Here, we introduce a soft wearable system (SWS), whose novel design, based on a soft polymer matrix embedding an array of fiber Bragg gratings, provides a good adhesion to the body and enables the simultaneous recording of SCG signals from multiple measuring sites. The feasibility assessment on healthy volunteers revealed that the SWS is a suitable wearable solution for HR monitoring and its performance in HR estimation is strongly influenced by sensor positioning and improved by a multi-sensor configuration. These promising characteristics open the possibility of using the SWS in monitoring patients with cardiac pathologies in clinical (e.g., during cardiac magnetic resonance procedures) and everyday life settings.

Validation and Assessment of a Posture Measurement System with Magneto-Inertial Measurement Units

Inappropriate posture and the presence of spinal disorders require specific monitoring systems. In clinical settings, posture evaluation is commonly performed with visual observation, electrogoniometers or motion capture systems (MoCaps). Developing a measurement system that can be easily used also in non-structured environments would be highly beneficial for accurate posture monitoring. This work proposes a system based on three magneto-inertial measurement units (MIMU), placed on the backs of seventeen volunteers on the T3, T12 and S1 vertebrae. The reference system used for validation is a stereophotogrammetric motion capture system. The volunteers performed forward bending and sit-to-stand tests. The measured variables for identifying the posture were the kyphosis and the lordosis angles, as well as the range of movement (ROM) of the body segments. The comparison between MIMU and MoCap provided a maximum RMSE of 5.6° for the kyphosis and the lordosis angles. The average lumbo-pelvic contribution during forward bending (41.8 ± 8.6%) and the average lumbar ROM during sit-to-stand (31.8 ± 9.8° for sitting down, 29.6 ± 7.6° for standing up) obtained with the MIMU system agree with the literature. In conclusion, the MIMU system, which is wearable, inexpensive and easy to set up in non-structured environments, has been demonstrated to be effective in posture evaluation.

Plant Wearable Sensors Based on FBG Technology for Growth and Microclimate Monitoring

Plants are primary resources for oxygen and foods whose production is fundamental for our life. However, diseases and pests may interfere with plant growth and cause a significant reduction of both the quality and quantity of agriculture products. Increasing agricultural productivity is crucial for poverty reduction and food security improvements. For this reason, the 2030 Agenda for Sustainable Development gives a central role to agriculture by promoting a strong technological innovation for advancing sustainable practices at the plant level. To accomplish this aim, recently, wearable sensors and flexible electronics have been extended from humans to plants for measuring elongation, microclimate, and stressing factors that may affect the plant’s healthy growth. Unexpectedly, fiber Bragg gratings (FBGs), which are very popular in health monitoring applications ranging from civil infrastructures to the human body, are still overlooked for the agriculture sector. In this work, for the first time, plant wearables based on FBG technology are proposed for the continuous and simultaneous monitoring of plant growth and environmental parameters (i.e., temperature and humidity) in real settings. The promising results demonstrated the feasibility of FBG-based sensors to work in real situations by holding the promise to advance continuous and accurate plant health growth monitoring techniques.

Skin Strain Analysis of the Scapular Region and Wearables Design

Monitoring scapular movements is of relevance in the contexts of rehabilitation and clinical research. Among many technologies, wearable systems instrumented by strain sensors are emerging in these applications. An open challenge for the design of these systems is the optimal positioning of the sensing elements, since their response is related to the strain of the underlying substrates. This study aimed to provide a method to analyze the human skin strain of the scapular region. Experiments were conducted on five healthy volunteers to assess the skin strain during upper limb movements in the frontal, sagittal, and scapular planes at different degrees of elevation. A 6 × 5 grid of passive markers was placed posteriorly to cover the entire anatomic region of interest. Results showed that the maximum strain values, in percentage, were 28.26%, and 52.95%, 60.12% and 60.87%, 40.89%, and 48.20%, for elevation up to 90° and maximum elevation in the frontal, sagittal, and scapular planes, respectively. In all cases, the maximum extension is referred to the pair of markers placed horizontally near the axillary fold. Accordingly, this study suggests interesting insights for designing and positioning textile-based strain sensors in wearable systems for scapular movements monitoring.

Temperature Monitoring in Hyperthermia Treatments of Bone Tumors: State-of-the-Art and Future Challenges

Bone metastases and osteoid osteoma (OO) have a high incidence in patients facing primary lesions in many organs. Radiotherapy has long been the standard choice for these patients, performed as stand-alone or in conjunction with surgery. However, the needs of these patients have never been fully met, especially in the ones with low life expectancy, where treatments devoted to pain reduction are pivotal. New techniques as hyperthermia treatments (HTs) are emerging to reduce the associated pain of bone metastases and OO. Temperature monitoring during HTs may significantly improve the clinical outcomes since the amount of thermal injury depends on the tissue temperature and the exposure time. This is particularly relevant in bone tumors due to the adjacent vulnerable structures (e.g., spinal cord and nerve roots). In this Review, we focus on the potential of temperature monitoring on HT of bone cancer. Preclinical and clinical studies have been proposed and are underway to investigate the use of different thermometric techniques in this scenario. We review these studies, the principle of work of the thermometric techniques used in HTs, their strengths, weaknesses, and pitfalls, as well as the strategies and the potential of improving the HTs outcomes.

Non-Contact Respiratory Monitoring Using an RGB Camera for Real-World Applications

Respiratory monitoring is receiving growing interest in different fields of use, ranging from healthcare to occupational settings. Only recently, non-contact measuring systems have been developed to measure the respiratory rate (fR) over time, even in unconstrained environments. Promising methods rely on the analysis of video-frames features recorded from cameras. In this work, a low-cost and unobtrusive measuring system for respiratory pattern monitoring based on the analysis of RGB images recorded from a consumer-grade camera is proposed. The system allows (i) the automatized tracking of the chest movements caused by breathing, (ii) the extraction of the breathing signal from images with methods based on optical flow (FO) and RGB analysis, (iii) the elimination of breathing-unrelated events from the signal, (iv) the identification of possible apneas and, (v) the calculation of fR value every second. Unlike most of the work in the literature, the performances of the system have been tested in an unstructured environment considering user-camera distance and user posture as influencing factors. A total of 24 healthy volunteers were enrolled for the validation tests. Better performances were obtained when the users were in sitting position. FO method outperforms in all conditions. In the fR range 6 to 60 breaths/min (bpm), the FO allows measuring fR values with bias of −0.03 ± 1.38 bpm and −0.02 ± 1.92 bpm when compared to a reference wearable system with the user at 2 and 0.5 m from the camera, respectively.

Validity Analysis of WalkerViewTM Instrumented Treadmill for Measuring Spatiotemporal and Kinematic Gait Parameters

The detection of gait abnormalities is essential for professionals involved in the rehabilitation of walking disorders. Instrumented treadmills are spreading as an alternative to overground gait analysis. To date, the use of these instruments for recording kinematic gait parameters is still limited in clinical practice due to the lack of validation studies. This study aims to investigate the performance of a multi-sensor instrumented treadmill (i.e., WalkerView^TM, WV) for performing gait analysis. Seventeen participants performed a single gait test on the WV at three different speeds (i.e., 3 km/h, 5 km/h, and 6.6 km/h). In each trial, spatiotemporal and kinematic parameters were recorded simultaneously by the WV and by a motion capture system used as the reference. Intraclass correlation coefficient (ICC) of spatiotemporal parameters showed fair to excellent agreement at the three walking speeds for steps time, cadence, and step length (range 0.502–0.996); weaker levels of agreement were found for stance and swing time at all the tested walking speeds. Bland–Altman analysis of spatiotemporal parameters showed a mean of difference (MOD) maximum value of 0.04 s for swing/stance time and WV underestimation of 2.16 cm for step length. As for kinematic variables, ICC showed fair to excellent agreement (ICC > 0.5) for total range of motion (ROM) of hip at 3 km/h (range 0.579–0.735); weaker levels of ICC were found at 5 km/h and 6.6 km/h (range 0.219–0.447). ICC values of total knee ROM showed poor levels of agreement at all the tested walking speeds. Bland–Altman analysis of hip ROM revealed a higher MOD value at higher speeds up to 3.91°; the MOD values of the knee ROM were always higher than 7.67° with a 60° mean value of ROM. We demonstrated that the WV is a valid tool for analyzing the spatiotemporal parameters of walking and assessing the hip’s total ROM. Knee total ROM and all kinematic peak values should be carefully evaluated, having shown lower levels of agreement.

Is age rating enough to investigate changes in breathing motion pattern associated with aging of physically active women?

The most common way to analyze the effect of aging on breathing is to divide subjects into age groups. However, in addition to the fact that there is no consensus in the literature regarding age group division, such design critically influences the interpretation of the effects attributed to aging. Thus, this study aimed to investigate the feasibility to distinguish different age groups from the 3D kinematic variables of breathing motion (i.e., markers' coordinate as a function of time allowing the calculation of compartmental volume variations) and to analyze whether the aging could influence these variables. Seventy-three physically active women aged 19-80 years performed quiet breathing and vital capacity maneuvers. To record the thoracoabdominal breathing motion, the 3D coordinates of 32 retroreflective markers positioned on the trunk were used to estimate the volume variation of the superior thorax, inferior thorax, and abdomen. The percentage of contribution and the correlation coefficient were calculated to analyze the breathing motion pattern from the estimated volumes. The k-means cluster analysis was performed to analyze the age group classification. Linear regression was performed to investigate whether age can predict changes in the breathing motion pattern. The results showed that physically active women could not be classified into age groups from breathing motion. Despite significant p values of the linear regression, the high variability of the data suggested that age itself is not enough to predict the changes in breathing motion pattern when non-sedentary women are considered.

Personalized, Predictive, Participatory, Precision, and Preventive (P5) Medicine in Rotator Cuff Tears

Rotator cuff (RC) disease is a common musculoskeletal disorder of the shoulder entailing pain, with reduced functionality and quality of life. The main objective of this study was to present a perspective of the current scientific evidence about personalized, predictive, participatory, precision, and preventive approaches in the management of RC diseases. The personalized, predictive, participatory, precision and preventive (P5) medicine model is an interdisciplinary and multidisciplinary approach that will provide researchers and clinicians with a comprehensive patrimony of knowledge in the management of RC diseases. The ability to define genetic predispositions in conjunction with the evaluation of lifestyle and environmental factors may boost the tailoring of diagnosis and therapy in patients suffering from RC diseases.

The influence of athletic performance on the highest positions of the final ranking during 2017/2018 Serie A season

Background

Our previous study on the 2016/2017 Serie A season showed that a greater likelihood of reaching the top positions in the Italian league “Serie A” seemed to be mainly related to sprint activity, goal attempts, total throws, target shots and assists. Therefore, we aim to evaluate the following season data in the same league to compare, confirm, and improve these results.

Methods

The data of all the matches played during the “Serie A” 2017–2018 season were obtained from the Italian soccer league. The teams’ analysis was performed in terms of total distance covered in km, jogging, running and sprint activities, average speed, and match statistics (total shots, shots on target, goal attempts, assists, turnovers, and steals).

Results

Teams that reached the first four positions revealed a lower percentage of running (65.98 ± 1.51 vs. 66.84 ± 2.18; p < 0.001), a higher percentage of jogging (25.61 ± 1.71 vs. 25.30 ± 1.97; p = 0.037) and sprint activities (8.41 ± 1.04 vs. 7.86 ± 0.82; p < 0.001). Match statistics seem to be statistically different between the first four teams the other teams. The total goals are strongly associated both with the total score at the end of the championship (R = 0.906; p < 0.001) and with the position in the final ranking (R = 0.850; p < 0.001).

Conclusions

Our results suggest that high-level teams have a lower running rate and a higher percentage of jogging and sprinting than other teams.

Techniques for Temperature Monitoring of Myocardial Tissue Undergoing Radiofrequency Ablation Treatments: An Overview

Cardiac radiofrequency ablation (RFA) has received substantial attention for the treatment of multiple arrhythmias. In this scenario, there is an ever-growing demand for monitoring the temperature trend inside the tissue as it may allow an accurate control of the treatment effects, with a consequent improvement of the clinical outcomes. There are many methods for monitoring temperature in tissues undergoing RFA, which can be divided into invasive and non-invasive. This paper aims to provide an overview of the currently available techniques for temperature detection in this clinical scenario. Firstly, we describe the heat generation during RFA, then we report the principle of work of the most popular thermometric techniques and their features. Finally, we introduce their main applications in the field of cardiac RFA to explore the applicability in clinical settings of each method.

Fiber Optic Sensors-Based Thermal Analysis of Perfusion-Mediated Tissue Cooling in Liver Undergoing Laser Ablation

The current challenge in the field of thermo-ablative treatments of tumors is to achieve a balance between complete destruction of malignant cells and safeguarding of the surrounding healthy tissue. Blood perfusion plays a key role for thermal ablation success, especially in the case of highly vascularized organs like liver. This work aims at monitoring the temperature within perfused swine liver undergoing laser ablation (LA). Temperature was measured through seven arrays of Fiber Bragg Grating sensors (FBGs) around the laser applicator. To mimic reality, blood perfusion within the ex-vivo liver was simulated using artificial vessels. The influence of blood perfusion on LA was carried out by comparing the temperature profiles in two different spatial configurations of vessels and fibers. The proposed setup permitted to accurately measure the heat propagation in real-time with a temperature resolution of 0.1 °C and to observe a relevant tissue cooling near to the vessel up to 65%.

Breath-Jockey: Development and Feasibility Assessment of a Wearable System for Respiratory Rate and Kinematic Parameter Estimation for Gallop Athletes

In recent years, wearable devices for physiological parameter monitoring in sports and physical activities have been gaining momentum. In particular, some studies have focused their attention on using available commercial monitoring systems mainly on horses during training sessions or competitions. Only a few studies have focused on the jockey's physiological and kinematic parameters. Although at a glance, it seems jockeys do not make a lot of effort during riding, it is quite the opposite. Indeed, especially during competitions, they profuse a short but high intensity effort. To this extend, we propose a wearable system integrating conductive textiles and an M-IMU to simultaneously monitor the respiratory rate (RR) and kinematic parameters of the riding activity. Firstly, we tested the developed wearable system on a healthy volunteer mimicking the typical riding movements of jockeys and compared the performances with a reference instrument. Lastly, we tested the system on two gallop jockeys during the "137∘ Derby Italiano di Galoppo". The proposed system is able to track both the RR and the kinematic parameters during the various phases of the competition both at rest and during the race.

Sclerostin Regulation, Microarchitecture, and Advanced Glycation End-Products in the Bone of Elderly Women With Type 2 Diabetes

Increased circulating sclerostin and accumulation of advanced glycation end-products (AGEs) are two potential mechanisms underlying low bone turnover and increased fracture risk in type 2 diabetes (T2D). Whether the expression of the sclerostin-encoding SOST gene is altered in T2D, and whether it is associated with AGEs accumulation or regulation of other bone formation-related genes is unknown. We hypothesized that AGEs accumulate and SOST gene expression is upregulated in bones from subjects with T2D, leading to downregulation of bone forming genes (RUNX2 and osteocalcin) and impaired bone microarchitecture and strength. We obtained bone tissue from femoral heads of 19 T2D postmenopausal women (mean glycated hemoglobin [HbA1c] 6.5%) and 73 age- and BMI-comparable nondiabetic women undergoing hip replacement surgery. Despite similar bone mineral density (BMD) and biomechanical properties, we found a significantly higher SOST (p = .006) and a parallel lower RUNX2 (p = .025) expression in T2D compared with non-diabetic subjects. Osteocalcin gene expression did not differ between T2D and non-diabetic subjects, as well as circulating osteocalcin and sclerostin levels. We found a 1.5-fold increase in total bone AGEs content in T2D compared with non-diabetic women (364.8 ± 78.2 versus 209.9 ± 34.4 μg quinine/g collagen, respectively; p < .001). AGEs bone content correlated with worse bone microarchitecture, including lower volumetric BMD (r = -0.633; p = .02), BV/TV (r = -0.59; p = .033) and increased trabecular separation/spacing (r = 0.624; p = .023). In conclusion, our data show that even in patients with good glycemic control, T2D affects the expression of genes controlling bone formation (SOST and RUNX2). We also found that accumulation of AGEs is associated with impaired bone microarchitecture. We provide novel insights that may help understand the mechanisms underlying bone fragility in T2D. © 2020 American Society for Bone and Mineral Research (ASBMR).

The Importance of Respiratory Rate Monitoring: From Healthcare to Sport and Exercise

Respiratory rate is a fundamental vital sign that is sensitive to different pathological conditions (e.g., adverse cardiac events, pneumonia, and clinical deterioration) and stressors, including emotional stress, cognitive load, heat, cold, physical effort, and exercise-induced fatigue. The sensitivity of respiratory rate to these conditions is superior compared to that of most of the other vital signs, and the abundance of suitable technological solutions measuring respiratory rate has important implications for healthcare, occupational settings, and sport. However, respiratory rate is still too often not routinely monitored in these fields of use. This review presents a multidisciplinary approach to respiratory monitoring, with the aim to improve the development and efficacy of respiratory monitoring services. We have identified thirteen monitoring goals where the use of the respiratory rate is invaluable, and for each of them we have described suitable sensors and techniques to monitor respiratory rate in specific measurement scenarios. We have also provided a physiological rationale corroborating the importance of respiratory rate monitoring and an original multidisciplinary framework for the development of respiratory monitoring services. This review is expected to advance the field of respiratory monitoring and favor synergies between different disciplines to accomplish this goal.

An fMRI Compatible Smart Device for Measuring Palmar Grasping Actions in Newborns

Grasping is one of the first dominant motor behaviors that enable interaction of a newborn infant with its surroundings. Although atypical grasping patterns are considered predictive of neuromotor disorders and injuries, their clinical assessment suffers from examiner subjectivity, and the neuropathophysiology is poorly understood. Therefore, the combination of technology with functional magnetic resonance imaging (fMRI) may help to precisely map the brain activity associated with grasping and thus provide important insights into how functional outcomes can be improved following cerebral injury. This work introduces an MR-compatible device (i.e., smart graspable device (SGD)) for detecting grasping actions in newborn infants. Electromagnetic interference immunity (EMI) is achieved using a fiber Bragg grating sensor. Its biocompatibility and absence of electrical signals propagating through the fiber make the safety profile of the SGD particularly favorable for use with fragile infants. Firstly, the SGD design, fabrication, and metrological characterization are described, followed by preliminary assessments on a preterm newborn infant and an adult during an fMRI experiment. The results demonstrate that the combination of the SGD and fMRI can safely and precisely identify the brain activity associated with grasping behavior, which may enable early diagnosis of motor impairment and help guide tailored rehabilitation programs.

Use of wearable systems for the detection of chest-abdominal wall movement aimed at respiratory monitoring in sport: a scoping review on available data

There is a significant request for wearable systems for vital signs and athletic performance monitoring during sport practice, both in professional and non-professional fields. Respiratory rate is a rather neglected parameter in this field, but several studies show that it is a strong marker of physical exertion. The aim of the present scoping review is to evaluate the number and kind of existing studies on wearable technologies for the analysis of the chest wall movement for respiratory monitoring in sport and fitness. The review included studies investigating the use of contact-based wearable techniques for the detection of chest wall movement for respiratory monitoring during professional or amateur sport, during fitness and physical activity. The search was conducted on PubMed/Medline, Scopus and Google Scholar electronic databases using keywords. Data extracted were entered into a Microsoft Excel spreadsheet by the leading author and then double-checked by the second author. A total of 25 descriptive studies met the inclusion criteria. Few studies on small number of athletes were found, technologies were often evaluated without a reference system, data on participants are sometimes missing. To date, we are not able to draw conclusions on which is the best and most reliable device to use during sport practice.

A Wearable Device Based on a Fiber Bragg Grating Sensor for Low Back Movements Monitoring

Low back pain (LBP) is one of the musculoskeletal disorders that most affects workers. Among others, one of the working categories which mainly experiences such disease are video terminal workers. As it causes exploitation of the National Health Service and absenteeism in workplaces, LBP constitutes a relevant socio-economic burden. In such a scenario, a prompt detection of wrong seating postures can be useful to prevent the occurrence of this disorder. To date, many tools capable of monitoring the spinal range of motions (ROMs) are marketed, but most of them are unusable in working environments due to their bulkiness, discomfort and invasiveness. In the last decades, fiber optic sensors have made their mark allowing the creation of light and compact wearable systems. In this study, a novel wearable device embedding a Fiber Bragg Grating sensor for the detection of lumbar flexion-extensions (F/E) in seated subjects is proposed. At first, the manufacturing process of the sensing element was shown together with its mechanical characterization, that shows linear response to strain with a high correlation coefficient (R² > 0.99) and a sensitivity value (S_ε) of 0.20 nm∙mε⁻¹. Then, the capability of the wearable device in measuring F/E in the sagittal body plane was experimentally assessed on a small population of volunteers, using a Motion Capture system (MoCap) as gold standard showing good ability of the system to match the lumbar F/E trend in time. Additionally, the lumbar ROMs were evaluated in terms of intervertebral lumbar distances (ΔdL3−L1) and angles, exhibiting moderate to good agreement with the MoCap outputs (the maximum Mean Absolute Error obtained is ~16% in detecting ΔdL3−L1). The proposed wearable device is the first attempt for the development of FBG-based wearable systems for workers’ safety monitoring.